Age/Reminders Vaccine Route Contraindications

Injectable Vaccine Administration for Adults age 19 years/Older1
Vaccine
Tetanus, diphtheria (Td)
Age/Reminders
Route
Age 7 years & older; May give more than 1 dose
Contraindications2
IM
Anaphylactic reaction to prior dose or
component; For Tdap: encephalopathy
within 7 days of previous pertussis vaccine
dose without other known cause
When indicated: Use Pediatric formulation for ages
19 years or younger & Adult formulation for ages
20 years or older
IM
Anaphylactic reaction to prior dose or
component (baker’s yeast)
When indicated: Use Adult formulation for ages
19 years or older;
2nd dose must be at least 6 months after 1st dose
IM
Anaphylactic reaction to prior dose or
component; hypersensitivity to alum
(Havrix® only: 2-phenoxyethanol)
Tetanus, diphtheria,
pertussis (Tdap)3
Routinely given as a single dose vaccine
Given to adults, including those age 65 years & older
Hepatitis B (hep B)
Hepatitis A (hep A)
Measles, Mumps, Rubella
(MMR)
If born in 1957 or later, assure 1 dose given; persons at high
risk, give 2 doses
SC
Anaphylactic reaction to prior dose or
component (neomycin, gelatin); pregnancy
Varicella (Var)
If born in 1980 or later, assure 2 doses given or have other
evidence of immunity
SC
Anaphylactic reaction to prior dose or
component (neomycin, gelatin); pregnancy
IM
Anaphylactic reaction to prior dose or
component
ID
Anaphylactic reaction to prior dose or
component
IM
Anaphylactic reaction to prior dose or
component
IM or
SC
Anaphylactic reaction to prior dose or
component
IM
Anaphylactic reaction to prior dose or
component
Males: HPV9/HPV4 ONLY; for aged 9-21 years & aged
22-26 years at high risk (men having sex with men or
immunocompromised)
IM
Anaphylactic reaction to prior dose or
component (HPV9/HPV4: baker’s yeast); not
indicated for use during pregnancy
Adults age 60 years and older
SC
Anaphylactic reaction to prior dose or
component (neomycin, gelatin); pregnancy
Influenza (IIV3 or IIV4)4
Give 1 dose during every flu season
(July 1st through June 30th)
Influenza High Dose
(IIV3 High Dose)
Age 65 years & older
Influenza Intradermal
(IIV3 ID)
Aged 18 through 64 years
(Must use IIV ID prefilled syringe only)
Pneumococcal Conjugate
(PCV13)5
Pneumococcal
Polysaccharide (PPSV23)5
Meningococcal
Conjugate (MCV4)6
Human Papillomavirus
(HPV9: Gardasil®-9)
(HPV4: Gardasil®)
(HPV2: Cervarix®)
Herpes Zoster (HZV)
Route
Site
Needle length/gauge
Persons 65 years or older, if previously unvaccinated, give
one dose of PCV13
Based on risk condition, persons 19-64 years, if previously
unvaccinated, may need one dose of PCV13
Give 1 dose to all persons aged 65 years or older
(Minimum 5 year interval if there was a previous dose)
Persons aged 2-64 years may need 1-2 doses based on
their risk condition
When indicated: for persons aged 2 months through
55 years; preferred for persons age 56 years or older
if previous dose of MCV4 given or multiple doses
needed (i.e., asplenia)
3-dose series for males and females
Females: HPV9/HPV4 or HPV2; for aged 9-26 years
IM = Intramuscular
Deltoid (preferred) or Anterolateral Thigh
1-1.5 inches/22-25 gauge
SC = Subcutaneous
Lateral Upper Arm or Anterolateral Thigh Area
5/8 inch/23-25 gauge
For information on travel vaccines, refer to: http://wwwnc.cdc.gov/travel. For further information on vaccines for adults, including Haemophilus influenzae type B (Hib), refer
to the Recommended Adult Schedule, including footnotes, at www.cdc.gov/vaccines
2 See package inserts for complete component listing (by brand); Refer to ACIP General Recommendations on Immunization & the Recommended Adult Schedule for a
comprehensive list of vaccine contraindications and precautions at www.cdc.gov/vaccines
3 Tdap licensure ages: Boostrix® (GSK) aged 10 years or older; Adacel® (Sanofi) for aged 10-64 years; either brand may be used for children aged 7-10 years; for persons
65 years & older, Boostrix® is preferred, but if unavailable Adacel® may be used.
4 Age indication for Inactivated Influenza Vaccine, trivalent (IIV3) or quadrivalent (IIV4) varies by brand. For information on any flu vaccine including cell-cultured IIV3 (ccIIV3)
or Recombinant Influenza Vaccine (RIV3), refer to package inserts or www.cdc.gov/flu
5 PCV13 should be administered prior to PPSV23; use a minimum interval of 8 weeks between PCV13 (if given 1st) and PPSV23; if PPSV23 given 1st, minimum interval of
one year prior to administering PCV13. Refer to the Recommended Adult Schedule, including footnotes, at www.cdc.gov/vaccines
6 MCV4 licensure ages: Menactra® (sanofi pasteur) aged 9 months-55 years & Menveo® (Novartis) aged 2 months-55 years; When indicated, MPSV4 (Meningococcal
Polysaccharide Vaccine) is preferred for persons 56 years or older if no previous history of meningococcal vaccination & anticipate needing only one dose (i.e., travel or
disease outbreak)
May 5, 2015
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